The first thing I want to say is You Are Not Alone. Pelvic organ prolapse (POP) affects around half of women over 40—and the older you get, the more common it becomes.

The prolapse of any organ sounds scary, but especially those as intimate as our pelvic ones! However, I want to remove the stigma and fear by decoding exactly what POP is, how to treat it, and the steps you can take to (hopefully!) prevent it.

What is Pelvic Organ Prolapse?

POP is when one or more of the pelvic organs slip from their normal position and push against the vagina.

The most common form of POP is cystocele, when the bladder pushes against the back wall of the vagina. However, the uterus, bowel, or top of the vagina can prolapse, creating pressure on one of the vaginal walls or end up protruding into the top of the vagina.

What Causes Pelvic Organ Prolapse?

The root of POP is a weak or dysfunctional pelvic floor. The pelvic floor is an amazing network of muscles, ligaments, and connective tissues that provides a supportive hammock for your pelvic organs. It is a key player in bladder and bowel control, sexual function, optimal core muscle control, and childbirth.

The pelvic floor muscles can become chronically weakened, over-stretched, or struggle to contract and release properly. As a result, the organs resting above these muscles start to slip out of place—and voila, prolapse!

What causes this to happen?

• Pregnancy, especially multiple pregnancies or carrying a large baby
• Aging (and menopausal hormonal changes)
• Long-term constipation or excessive straining when passing stools
• Being overweight
• Hysterectomy
• Chronic physical strain caused by heavy lifting—at work or the gym!
• Joint hypermobility and related conditions, such as Ehlers-Danlos and Marfan syndromes.

Although one major physical event, such as pregnancy, can cause a prolapse, it often occurs due to an accumulation of factors.

How Do I Know If I Have Pelvic Organ Prolapse?

The most common symptoms of POP are:

• A heavy feeling in your tummy, pelvis, or genitals
• Feeling or seeing a bulge in or extending from your vagina
• General discomfort in your vagina
• Numbness or pain during intercourse
• Urine leaking when exercising, coughing, or sneezing (known as stress incontinence)
• Feeling the urge to go to the toilet more frequently or feeling unable to empty your bladder completely
• Pelvic or lower back pain
• Trouble passing stools

A major symptom of POP is how it affects your quality of life. This means everything from how able or confident you feel in carrying out your daily tasks to your mental and emotional wellbeing.

Depending on the nature of the prolapse—how severe it is and what muscles and organs are affected—will determine what symptoms you experience. You can even have a mild symptom-free prolapse, which a healthcare practitioner may discover during a routine check-up or pap smear.

Diagnosing and Treating Pelvic Organ Prolapse

POP is an umbrella term, so the first stage of diagnosis is a pelvic exam by your healthcare provider to determine the nature of the prolapse and the severity of your symptoms. The next stage is treatment!

Why Choose Physical Therapy for Treating Pelvic Organ Prolapse

There are several treatment options for POP, from surgery to pessaries to physical therapy. All treatment routes have their place, but (and yes, I am biased!) studies frequently show that pelvic floor physical therapy is highly effective in managing the symptoms of POP and improving quality of life.

Pelvic floor physical therapy often means more than just managing a prolapse because our pelvic floor muscles have multiple vital jobs. They assist in essential bodily processes and play a key role in functional movement, good posture, and circulation. So, treating POP with physical therapy helps ensure a critical muscle group is doing its job correctly—which may help prevent everything from back pain to incontinence down the line!

Pelvic floor physical therapy also works well in combination with other POP treatments, including pessaries. Significantly, the outcome of vaginal and POP surgeries has been shown to have better results when combined with pelvic floor physical therapy.

Can I Prevent Pelvic Organ Prolapse?

This is a tough one—sometimes you do everything right, and what you try to avoid still happens! However, there are steps you can take to minimize your risk. We know that POP is correlated with aging in women due to tissue and hormonal changes.

Routine check-ups with a Women’s Health PT to assess the health of your pelvic floor and help you develop a wellbeing plan to keep your pelvic floor muscles in the best shape possible can be a great preventative step!

Physical Therapy for Pelvic Organ Prolapse

As the pelvic floor is a specialized group of muscles, I recommend working with a practitioner trained in pelvic health. A Women’s Health or Pelvic Health PT will develop a set of exercises specifically designed for your body and the nature of your prolapse.

The word ‘Kegel’ is thrown around for treating or preventing POP; however, it’s essential to learn how to do it properly—it’s not just a matter of squeezing the muscles of your nether regions! Unfortunately, when practiced incorrectly, Kegels can lead to tense but weak pelvic floor muscles and create more problems in the long run.

Sylvie Le takes a multi-faceted approach to addressing the health and function of your pelvic floor muscles, and combines PT exercises with therapeutic yoga techniques, to help ensure proper spinal alignment and breathing practices. POP is known to have a considerable effect on quality of life, and these techniques help promote greater wellbeing, which can positively impact healing.

If you are struggling with POP or want to take steps to prevent it, make an appointment with Sylvie Le today!

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Author: Sylvie Le, DPT, PYTC